Cps Ii Pud

Front 1

Most pts with PUD are what sex?

Back 1

male

Front 2

Duodenal ulcers are how many more times more common than gastric ulcers?

Back 2

3x

Front 3

For PUD, elimination of what reduces reoccurrence by half?

Back 3

H. Pylori

Front 4

In pts w/out H.plyori what is the MCC of PUD?

Back 4

NSAIDS

Front 5

What are involved in 50% of perforated ulcers?

Back 5

NSAIDS

Front 6

What is Zollenger-Ellison syndrome?

Back 6

neuro-endocrine pancreatic tumore that secretes excessive gastrin which stimulates stocmach to produce excessive acid leading to ulcers

Front 7

Dx/Dx for PUD

Back 7

-GERD
-Pancreatitis
-Crohn's
-gastritis
-cholelithiasis/cystitis
-gastric CA
-CAD/Angina
-hiatal hernia

Front 8

Pts with PUD often get what type of epigastric pain?

Back 8

gnawing

Front 9

Pain with PUD is often worse when?

Back 9

at night or on an empty stomach

Front 10

Pain with PUD is often relieved with what?

Back 10

food and antacids

Front 11

Most pts with PUD are what sex?

Back 11

male

Front 12

Duodenal ulcers are how many more times more common than gastric ulcers?

Back 12

3x

Front 13

For PUD, elimination of what reduces reoccurrence by half?

Back 13

H. Pylori

Front 14

In pts w/out H.plyori what is the MCC of PUD?

Back 14

NSAIDS

Front 15

What are involved in 50% of perforated ulcers?

Back 15

NSAIDS

Front 16

What is Zollenger-Ellison syndrome?

Back 16

neuro-endocrine pancreatic tumore that secretes excessive gastrin which stimulates stocmach to produce excessive acid leading to ulcers

Front 17

Dx/Dx for PUD

Back 17

-GERD
-Pancreatitis
-Crohn's
-gastritis
-cholelithiasis/cystitis
-gastric CA
-CAD/Angina
-hiatal hernia

Front 18

Pts with PUD often get what type of epigastric pain?

Back 18

gnawing

Front 19

Pain with PUD is often worse when?

Back 19

at night or on an empty stomach

Front 20

Pain with PUD is often relieved with what?

Back 20

food and antacids

Front 21

What are some other S/S for PUD?

Back 21

-bloating
-belching
-heartburn
-decreased appetite or intolerance of provacative foods
-epigastric tenderness to palpation

Front 22

What are some things that suggest a bleeding ulcer?

Back 22

-coffee ground emesis
-melana
-anemia
-OH

Front 23

What are some things that suggest acute abdomen disease?

Back 23

-intense generalized diffuse abdominal pain
-rigidity
-rebound tenderness
-worse with movement
-fever

Front 24

What are some alarming symptoms when you inspect for PUD?

Back 24

-anemia
-weight loss
-hematemesis
-persistent pain
-melena
-heme positive stool
-peritoneal signs
-vomiting of partially digested foods

Front 25

In a younger pt with no alarm symptoms, what labs to you do?

Back 25

test for H.pylori and treat

Front 26

If a person is >55 with alarm symptoms who fails empiric therapy for PUD, what shoud you do?

Back 26

EGD

Front 27

What is a qualitative and quantitative test for H.Pylori?

Back 27

-finger stick

-ELISA

Front 28

What are some other tests you can do to check for H.pylori?

Back 28

-urea breath test
-stool antigen
-histological testing with endoscopy biopsy sample

Front 29

For tx of PUD you want to pt to stop what?

Back 29

-NSAIDS
-alcohol
-coffee
-cigarettes

Front 30

If a pts test positive for H.pylori you must you what?

Back 30

triple therapy

Front 31

What are some triple therapy options for the tx of PUD?

Back 31

you need 2 abx plus an acid suppressor for 2 weeks

-Amox 1000mg BID plus clarithromycin 500 mg BID plus Lansoprazole 30 mg BID

-Metroniadazole 250mg QID plus Tetracycline 500mg QID plus Bismuth subsalicylate 525mg QID plus Ranitidine 150 mg BID

Front 32

For PUD, the PPI is usally continued for how long?

Back 32

4 weeks

Front 33

What works better, PPI or H2 blocker?

Back 33

PPI

Front 34

What is the tx for PUD if H.pylori is negative?

Back 34

-PPI for 4 weeks

-H2 blocer for 4 weeks

-sulcralfate for 4 weeks

Front 35

What is the tx for PUD if pts has evidence of GI bleeding and is hemodynamically stable?

Back 35

-IV PPI
-test for H.plyori
-perform EGD

Front 36

What is the tx for PUD if pt has evidence of GI bleeding and is not hemodynamically stable?

Back 36

-O2, IV, monitor
-fluid resuscitation w/NS or PRBC
-urgent EGD with ligation
-epi or sclerosing agent

Front 37

What are some sequella to PUD?

Back 37

-bleeding
-OH
-anemia
-weight loss
-bastric outlet obstruction
-perforation leading to peritonitis

Front 38

What are some Pearls/Pitfalls of PUD?

Back 38

-most ulcers are caused by H.plyori or NDSAIDS
-spicy food do NOT cause ulcers
-acohol, coffee, cigarettes contribute to ulcers
-be alert for alarm symptoms
-be aware of high risk pts
-always test for H.pylori